Gerald Thomas

The raising of minimum alcohol prices in Saskatchewan, Canada: Impacts on consumption and implications for public health.

OBJECTIVES We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada. METHODS We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention. RESULTS A 10% increase in minimum prices significantly reduced consumption of beer by 10.06%, spirits by 5.87%, wine by 4.58%, and all beverages combined by 8.43%. Consumption of coolers decreased significantly by 13.2%, cocktails by 21.3%, and liqueurs by 5.3%. There were larger effects for purely off-premise sales (e.g., liquor stores) than for primarily on-premise sales (e.g., bars, restaurants). Consumption of higher strength beer and wine declined the most. A 10% increase in minimum price was associated with a 22.0% decrease in consumption of higher strength beer (> 6.5% alcohol/volume) versus 8.17% for lower strength beers. The neighboring province of Alberta showed no change in per capita alcohol consumption before and after the intervention. CONCLUSIONS Minimum pricing is a promising strategy for reducing the public health burden associated with hazardous alcohol consumption. Pricing to reflect percentage alcohol content of drinks can shift consumption toward lower alcohol content beverage types.

Alcohol in Canada: reducing the toll through focused interventions and public health policies

In high-income countries like Canada, alcohol consumption ranks second (behind tobacco use) as an etiologic risk factor in the World Health Organization (WHO) burden of disease studies.[1][1],[2][2] Based on 2002 data, the estimated annual cost in Canada for health care directly related to alcohol

An adaptation of the Yesterday Method to correct for under-reporting of alcohol consumption and estimate compliance with Canadian low-risk drinking guidelines.

ObjectivesTo estimate compliance with Canada’s Low-Risk Alcohol Drinking Guidelines (LRDG) in different groups of drinkers after adjusting for underreporting of alcohol use, and to identify which types of beverage are more likely to be consumed when LRDGs are exceeded.MethodOur sample consisted of 43,242 Canadians aged 15 and over who had responded to the Canadian Alcohol and Drug Use Monitoring Survey, 2008–2010. Consumption in excess of LRDG was estimated for subgroups of drinkers after adjustment for under-reporting of consumption. Responses to Beverage-Specific Yesterday questions were used to make age-, gender- and beverage-specific corrections to under-reporting for data from the last 12 months Quantity-Frequency questions. Statistics Canada data on sales of beer, wine and spirits were also incorporated into the adjusted calculations.ResultsAfter adjustment for under-reporting, non-compliance with weekly LRDG limits to reduce risk of long-term harm increased from 6.8% to 27.3% among drinkers, and from 42.3% to 68.3% with respect to drinks. Non-compliance with daily LRDG limits to reduce risk of short-term harm increased from 16.7% to 38.6% among drinkers, and from 53.3% to 80.5% with respect to drinks. After adjustment, over 92% of total consumption occurred on risky drinking days among underage Canadians and over 91% of consumption reported by young adults took place during risky drinking occasions. Wine was least likely to be drunk in a risky fashion, spirits were the most likely.ConclusionWhen corrections for under-reporting are made, most Canadian alcohol consumption occurs on days when national LRDG are exceeded, especially for underage and young adult drinkers.RésuméObjectifsEstimer le respect des Directives de consommation d’alcool à faible risque du Canada (DCFR) au sein de divers groupes de buveurs après avoir tenu compte de la sous-déclaration de la consommation d’alcool et déterminer quels types de boissons sont les plus susceptibles d’être consommées lorsque les DCFR sont dépassées.MéthodeNotre échantillon était composé de 43 242 Canadiens âgés de 15 ans et plus qui ont répondu à l’Enquête de surveillance canadienne de la consommation d’alcool et de drogues, 2008–2010. On a estimé la consommation dépassant les DCFR après ajustement de la sous-déclaration de la consommation des sous-groupes de buveurs. Les réponses aux questions Propre à une boisson-Hier ont servi à corriger la sous-déclaration liée à l’âge, au genre et à la boisson particulière des données des 12 derniers mois des questions Quantité-Fréquence. Les données de Statistique Canada sur la vente de bière, de vin et de spiritueux ont également été incorporées aux calculs ajustés.RésultatsAprès avoir tenu compte de la sous-déclaration, la non-conformité aux limites hebdomadaires des DCFR pour réduire le risque de dommage à long terme est passée de 6,8 % à 27,3 % parmi les buveurs et de 42,3 % à 68,3 % quant aux consommations alcooliques. La non-conformité aux limites quotidiennes des DCFR pour réduire le risque de dommage à court terme est passée de 16,7 % à 38,6 % parmi les buveurs et de 53,3 % à 80,5 % quant aux consommations alcooliques. Après ajustement, plus de 92 % de la consommation totale s’est produite les jours de consommation d’alcool risqués chez les mineurs canadiens et plus de 91 % de la consommation déclarée des jeunes adultes s’est produite lors d’occasions risquées de consommer. Le vin était la boisson la moins susceptible d’être consommée et les spiritueux, les plus susceptibles de l’être.ConclusionUne fois les corrections apportées pour tenir compte de la sous-déclaration, la consommation d’alcool de la plupart des Canadiens se produit les jours pendant lesquels les DCFR nationales sont dépassées, en particulier chez les buveurs mineurs et chez les jeunes adultes.

A Complex Picture: Trends in alcohol consumption, harms and policy: Canada 1990–2010

This paper examines access to alcohol, trends in consumption, drinking patterns, damage from alcohol, and developments in prevention and alcohol policy – focusing on the Canadian experience over the last two decades. Consumption, as measured by official sales, declined initially and then has increased since 1996. During this time there was a gradual increase in access to alcohol, with steeper increase in some jurisdictions undergoing partial or full privatization of retail alcohol sales. According to survey data, the proportion drinking in a high risk manner is greater among youth and young adults, and the trend in the proportion of high risk drinkers does not necessarily follow the trend in alcohol sales. In light of intensive and multi-dimensional efforts to curtail drinking and driving, these rates have gone down during the period under study. Several provinces have introduced alcohol strategies and a national strategy introduced in 2007 is being implemented. Nevertheless there are ongoing challenges of getting alcohol on the broader public health agenda, even though it is major contributor to disease and disability. The rising consumption and increased access to alcohol, combined with intensive marketing, represent a major public health challenge. It is unlikely that there will be significant strides in reducing the damage from alcohol to Canadian populations, unless there is a substantial change in the status quo involving implementation of the most effective policies and prevention strategies.

Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities

INTRODUCTION AND AIMS Alcohol pricing is an effective prevention policy. This paper compares the 10 Canadian provinces on three research-based alcohol pricing policies-minimum pricing, pricing by alcohol content and maintaining prices relative to inflation. DESIGN AND METHODS The selection of these three policies was based on systematic reviews and seminal research papers. Provincial data for 2012 were obtained from Statistics Canada and relevant provincial ministries, subsequently sent to provincial authorities for verification, and then scored by team members. RESULTS All provinces, except for Alberta, have minimum prices for at least one beverage type sold in off-premise outlets. All provinces, except for British Columbia and Quebec, have separate (and higher) minimum pricing for on-premise establishments. Regarding pricing on alcohol content, western and central provinces typically scored higher than provinces in Eastern Canada. Generally, minimum prices were lower than the recommended

Strategies to reduce alcohol-related harms and costs in Canada: A comparison of provincial policies

1.50 per standard drink for off-premise outlets and

The effectiveness of alcohol warning labels in the prevention of Fetal Alcohol Spectrum Disorder: A brief review

3.00 per standard drink in on-premise venues. Seven of 10 provinces scored 60% or higher compared to the ideal on indexing prices to inflation. Prices for a representative basket of alcohol products in Ontario and Quebec have lagged significantly behind inflation since 2006. DISCUSSION AND CONCLUSIONS While examples of evidence-based alcohol pricing policies can be found in every jurisdiction in Canada, significant inter-provincial variation leaves substantial unrealised potential for further reducing alcohol-related harm and costs. This comparative assessment of alcohol price policies provides clear indications of how individual provinces could adjust their pricing policies and practices to improve public health and safety. [Giesbrecht N, Wettlaufer A, Thomas G, Stockwell T, Thompson K, April N, Asbridge M, Cukier S, Mann R, McAllister J, Murie A, Pauley C, Plamondon L, Vallance K. Pricing of alcohol in Canada: A comparison of provincial policies and harm-reduction opportunities. Drug Alcohol Rev 2016;35:289-297].